Exploring the Rare Occurrence of Giant Cell Tumour in Distal Tibia.

Introduction: Giant cell tumours (GCT) of the distal tibia are uncommon, locally aggressive lesions that are frequently difficult to manage due to the anatomical and functional intricacies of the region. This case study seeks to elucidate the clinical presentation, surgical procedures, and results in three individuals with distal tibial giant cell tumours, highlighting management and reconstructive techniques in this uncommon location with higher risk of morbidity compared to other locations and to achieve pain free ambulation. Materials and methods: Three cases presenting with localised pain and swelling with painful weight-bearing in the distal tibia, were included in the study. Two patients had primary GCT whereas one had recurrence of the tumour after being managed elsewhere. All patients had biopsy and radiologically proven GCT with differing degrees of local aggressiveness. The management strategy involved wide-margin tumour resection followed by reconstruction techniques including contralateral fibular strut grafting and ankle arthrodesis with cementation and bone graft to restore structural integrity and functionality. Results: All three patients underwent successful tumour resection and reconstruction without major intra-operative complications. Radiological assessments confirmed adequate union of grafts and no signs of recurrence during follow-up. Conclusion: This series highlights the efficacy of various modalities for the treatment of GCT of distal tibia. While these methods demonstrate promising results in terms of stability and patient satisfaction, vigilance for recurrence and long-term complications remains critical.